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When should you go to the hospital?

If someone has flu-like symptoms, but is otherwise healthy, not a whole lot can be done by going to an emergency department, Dr. Dan Ricciuto noted.

"Stay at home, rest and don't come in contact with others, like going out to a mall," he said. "The very ill, elderly, young or with underlying issues need to come into the emergency. They may need to be admitted to hospital."

That, he noted, would be a small number of people.

While it might not sound appealing, the doctor said it would be a "good idea to tough it out at home" instead of heading to an emergency department.

Dr. Ricciuto noted antibiotics don't work against the flu virus.

Anti-virals, such as Tamiflu, do work against the virus, but he said, "Tamiflu may only save you 24 hours of illness. It won't have a major impact on the course of the influenza."

Someone sick with the flu and going to an emergency department could infect "quite a few people coming in at the same time, it's possible to catch something or spread something," the doctor said.

DURHAM -- There's been a jump in the past few weeks in the number of people suffering from the flu.

Durham Region health department officials have been tracking the number of cases and parts of the region have seen "a very large spike. It started the week of Dec. 16," said Anne Grant, a senior public health inspector for Durham.

"We don't know the reason," she said, adding the virus is unpredictable.

"We did see an earlier start to influenza this season, but it's not outside the range" of when flu cases are seen, she said.

Dr. Dan Ricciuto, an infectious disease specialist and the infection and prevention control lead at Lakeridge Health, said the flu has hit across North America, but noted, "Ontario has been hit especially hard."

The peak is early this year, he said.

"We usually see the peak in late January. This season it's early December. In the last three weeks, we're seeing a lot of cases in increasing amounts."

Dr. Gary Mann, program chief in the department of emergency medicine at the Rouge Valley Ajax and Pickering hospital, said flu seasons typically run about eight weeks and the current one has reached six weeks.

"Typically, we reach the 150 to 170 (people in ER per day) mark. We've been in excess of 200 patients per day. It's the same at Centenary (hospital)," Dr. Mann said.

One of the "major factors" in more people coming to the ER is family doctors weren't seeing patients over the holidays, he said, adding walk-in clinics and urgent care sites were closed.

"People felt they had no alternative and people were coming to the emergency department," Dr. Mann noted.

There have been 62 reported flu cases, but Ms. Grant said, "That's the tip of the iceberg of people with influenza."

Many family doctors, knowing a patient has influenza, might not do a swab to confirm a flu case, she noted.

"The 62 are laboratory confirmed," Ms. Grant said. "It's a tip of the iceberg of the number of cases in our community."

Influenza is a reportable disease, but she added, "Only individuals with a laboratory confirmation are the only ones reported to us."

"Definitely in the last month, there's been a significant increase compared to the same time in previous years," Dr. Ricciuto said. "It's not just in emerg. (Doctors) are seeing a lot of cases coming into their offices as well."

Most family doctors don't test for influenza, as most respiratory tract infections at this time are flu-related, he noted.

There are three types of flu strains primarily being seen this season -- influenza A H3N2, influenza A H1N1 and influenza B.

Most of the cases are the strain influenza A H3N2, Dr. Ricciuto said, adding this year's flu vaccine will protect against that strain.

"Those who have the vaccine will find the signs and symptoms less severe and it will last for a shorter duration of time. You'll be lethargic for a day or two. It will feel like the common cold," she said.

Dr. Ricciuto agreed, saying "The more people who aren't immunized, the longer this will go on. There's still time to be vaccinated."

Flu symptoms include fever, cough, sore throat, severe headaches and body aches. In children, there's vomiting and diarrhea. The flu can last up to seven days, although some will be sick longer, Ms. Grant said, adding most flu sufferers will be in bed for two or three days.

"Not everyone with influenza needs medical attention," she said.

Anyone with flu-like symptoms should "stay at home so they don't spread the virus to others in the community or in the workplace. Drink plenty of fluids. Treat your symptoms. If you get really ill, see your physician," Ms. Grant added.

High-risk groups, such as young children, the elderly and those with chronic illnesses, "aren't that more likely to get influenza. Everyone is at risk. They have an increased risk of having secondary risks, such as pneumonia, bronchitis and ear infections in children."

Dr. Mann always asks patients who come into the ER with the flu if they've been vaccinated and "more than 50 per cent have not had a shot. I still encourage people to get a shot. Just because it's coming to the end doesn't mean you can't get it."

Anyone with the flu or flu-like symptoms should visit their family doctor, he advised.